Provider Demographics
NPI:1104913821
Name:HORST, GRETCHEN DORR (LCSW)
Entity type:Individual
Prefix:MRS
First Name:GRETCHEN
Middle Name:DORR
Last Name:HORST
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:429B CARLISLE DR # 205
Mailing Address - Street 2:
Mailing Address - City:HERNDON
Mailing Address - State:VA
Mailing Address - Zip Code:20170-4802
Mailing Address - Country:US
Mailing Address - Phone:703-391-7380
Mailing Address - Fax:703-783-8655
Practice Address - Street 1:429B CARLISLE DR # 205
Practice Address - Street 2:
Practice Address - City:HERNDON
Practice Address - State:VA
Practice Address - Zip Code:20170-4802
Practice Address - Country:US
Practice Address - Phone:703-391-7380
Practice Address - Fax:703-783-8655
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2024-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040015671041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA102938OtherANTHEM
DCG01545T01Medicare PIN